Exploring the effects of a wearable biocueing app (Sense-IT) as an addition to aggression regulation therapy in forensic psychiatric outpatients
A wrist buzzer added to anger therapy helps a couple clients, not the whole caseload.
01Research in Context
What this study did
Forensic outpatients got a wristband that buzzed when their heart rate jumped. The buzz reminded them to use the aggression skills they learned in therapy.
Twenty-five adults kept the band on for several weeks. They also filled out short surveys about anger and body signals.
What they found
Most people said they felt less angry and noticed body cues better. Daily wrist data, however, showed clear gains for only two people.
The app helped a little, but it did not turn the whole group around.
How this fits with other research
van Swieten et al. (2025) saw the same small win. Their band told adults with mild ID to play music when stress rose. Both studies show wearables can nudge self-regulation, yet the effect stays modest.
Ruby et al. (2022) flipped the camera. They gave staff, not clients, a tablet to count their own positive talk. Staff behavior tripled, while client change here was tiny. The lesson: who holds the tech matters.
Chezan et al. (2019) ran a five-week group for youth with ASD. Parents loved it, but quality-of-life scores stayed flat. Like here, warm feelings did not match hard numbers.
Why it matters
If you run anger groups, try a bio-buzz band as a side dish, not the main course. Expect one or two clients to shine. Track daily data so you know who they are, and keep teaching the hands-on skills that work without wires.
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02At a glance
03Original abstract
Preventing and reducing violence is of high importance for both individuals and society. However, the overall efficacy of current treatment interventions aimed at reducing aggressive behavior is limited. New technological-based interventions may enhance treatment outcomes, for instance by facilitating out-of-session practice and providing just-in-time support. Therefore, the aim of this study was to assess the effects of the Sense-IT biocueing app as an addition to aggression regulation therapy (ART) on interoceptive awareness, emotion regulation, and aggressive behavior among forensic outpatients. A combination of methods was used. Quantitatively, a pretest-posttest design was applied to explore group changes in aggression, emotion regulation, and anger bodily sensations associated with the combination of biocueing intervention and ART. Measures were assessed at pretest, after 4 weeks posttest, and after one-month follow-up. During the 4 weeks, a single-case experimental ABA design was applied for each participant. Biocueing was added in the intervention phase. During all phases anger, aggressive thoughts, aggressive behavior, behavioral control, and physical tension were assessed twice a day, and heart rate was measured continuously. Qualitative information regarding interoceptive awareness, coping, and aggression was collected at posttest. 25 forensic outpatients participated. A significant decrease in self-reported aggression was found between pre- and posttest. Furthermore, three-quarters of participants reported increased interoceptive awareness associated with the biocueing intervention. However, the repeated ambulatory measurements of the single-case experimental designs (SCEDs) did not indicate a clear effect favoring the addition of biocueing. On group level, no significant effects were found. On the individual level, effects favoring the intervention were only found for two participants. Overall, effect sizes were small. Biocueing seems a helpful addition to increase interoceptive awareness among forensic outpatients. However, not all patients benefit from the current intervention and, more specifically, from its behavioral support component aimed at enhancing emotion regulation. Future studies should therefore focus on increasing usability, tailoring the intervention to individual needs, and on integration into therapy. Individual characteristics associated with effective support by a biocueing intervention should be further investigated, as the use of personalized and technological-based treatment interventions is expected to increase in the coming years.
Frontiers in Psychology, 2023 · doi:10.3389/fpsyg.2023.983286